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目的探讨Ahmed青光眼阀(AGV)引流盘包裹切除联合羊膜移植治疗难治性青光眼的有效性、安全性,并讨论其可能的机制。方法对20例24眼难治性青光眼再手术患者,切除Ahmed青光眼阀纤维包裹,并植入羊膜,观察术后眼压、滤过泡、前房、视力等情况,术后随访1～24个月,平均随访(8·2±4·5)个月,观察术后疗效。结果术后无浅前房等并发症,术后及随访期间眼压与术前比较均有降低,差异有统计学意义(P<0·005),滤过泡均为功能性滤过泡,视力保持不变或有所改善,手术完全成功率达84·8%。结论羊膜在Ahmed青光眼阀门植入术失败后再手术的应用明显提高了手术成功率,联合丝裂霉素C的应用可减少其远期并发症,使手术操作简便、易行、安全,值得在临床推广应用。
Objective To investigate the efficacy and safety of Ahmed glaucoma valve (AGV) drainage disc combined with amniotic membrane transplantation in the treatment of refractory glaucoma and to discuss its possible mechanism. Methods A total of 20 patients (24 eyes) with intractable glaucoma reoperation were enrolled. Ahmed glaucoma valve fibers were excised and amniotic membrane was implanted. Intraocular pressure (IOP), filtration bleb, anterior chamber and visual acuity were observed. Month, followed up for an average of (8.2 ± 4.5) months. The curative effect was observed. Results No postoperative complications such as anterior chamber aneurysm were observed. The intraocular pressure (IOP) and intraocular pressure (IOP) after operation were lower than those before operation, the difference was statistically significant (P <0 · 005) Visual acuity remained unchanged or improved, the complete success rate of surgery was 84.8%. Conclusions The application of amniotic membrane after Ahmed glaucoma valve failure fails to improve the surgical success rate significantly, the combination of mitomycin C can reduce its long-term complications, so that the operation is simple, easy and safe, it is worth Clinical application.